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Postoperative rise in serum sodium level, an indicator of diabetes insipidus after pituitary adenoma surgery
EANS Academy. Noor Ul Huda M. 09/25/19; 275291; EP04047
Dr. Maria Noor Ul Huda
Dr. Maria Noor Ul Huda

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Abstract
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Objective: To study the efficacy of post operative rise in serum sodium level as indicator of diabetes insipidus after pituitary adenoma surgery.
Methodology: The study is randomized control trail. It was conducted in Departments of Neurosurgery and Biochemistry Punjab Institute of Neurosciences/Lahore General Hospital/Postgraduate Medical Institute/Ameeruddin Medical College from March 2016 to December 2017. 169 patients was enrolled for transsphenoidal surgery of their pituitary adenoma. Non probability consecutive sampling technique was used to collect the sample size. Postoperative evidence of diabetes insipidus by measuring rise in serum sodium level >145mEq. Mean and standard deviation was calculated for demographic variables frequency and percentage was calculated for outcome variables like type of diabetes insipidus and sensitivity and specificity of serum sodium >145mEq test. Chi square test was applied.
Results: n=169 patients were enrolled.Post-operative transient noted in 13.6% (n=23) patients. Serum sodium level, > 145 mEq was observed in 88.2% (n=149) patients. The main outcome variable of this study was diabetes insipidus permanent, in our study, it was noted in 9.5% (n=16) patients. The main outcome variable of this study was diabetes insipidus permanent, in our study, it was noted in 9.5% (n=16) patients.Out of these 9.5% patients ~82 (n=13) had hypernatremia with an average ~>147 Post-operative transient noted in 13.6% (n=23) patients .In this group again ~ 80% had hypernatremia (n=19) These results showed that the presenence of hypernatremia is indeed an indicator of diabetes insipidus as it is seen in ~80% of the patients who developed postoperative diabetes insipidus.Combined with polyuria >200ml/hr , polydipsia , serum hyperosmolarity ,urinary hyposmolarity .
Conclusion: From this study we conclude that level of sodium >145mEq is very sensitive and specific test which can be used to predict the outcome after pituitary adenoma surgery in the form of Diabetes Insipidus.
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